World journal of experimental medicine最新文献

{"title":"Clinical hypnosis in pediatric care: An adjunctive tool or therapeutic illusion.","authors":"Mohammed Al-Beltagi","doi":"10.5493/wjem.v15.i4.114554","DOIUrl":"10.5493/wjem.v15.i4.114554","url":null,"abstract":"<p><p>Clinical hypnosis has been proposed as a non-pharmacological intervention in pediatric healthcare, drawing on children's natural capacity for imagination and focused attention. It has been applied across a broad spectrum of medical and psychological conditions, yet its true clinical value remains a matter of debate. This narrative review synthesizes findings from randomized controlled trials, cohort studies, systematic reviews, and clinical case series on pediatric hypnotherapy. Literature was selected based on relevance, methodological quality, and diversity of application. Evidence suggests that pediatric hypnosis may reduce acute and chronic pain, support management of functional gastrointestinal disorders, alleviate anxiety and habit disorders, improve sleep, and provide symptom relief in chronic diseases such as cancer and cystic fibrosis. Techniques are individualized and developmentally tailored, often using guided imagery, storytelling, and self-hypnosis. Reported benefits include reduced symptom burden, decreased reliance on medications, and improved quality of life. However, the strength of evidence varies considerably across conditions. Limitations include a shortage of large-scale trials, variability in individual responsiveness, limited availability of trained clinicians, and ongoing skepticism from healthcare providers and caregivers. While pediatric hypnosis may show promise as a safe and empowering adjunctive therapy, its clinical efficacy remains to be firmly established across all conditions. Further large-scale, methodologically rigorous research is required to clarify its actual benefits, cost-effectiveness, and role within integrative, evidence-based pediatric care.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"114554"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pinocembrin as a novel anti-cancer agent: Exploring preclinical evidence along with therapeutic potential.","authors":"Neelam Singla, Piyush Mittal, M Arockia Babu, Soumya V Menon, Subhashree Ray, Haider Ali, Manish Purohit, Kavita Goyal, Rakhi Mishra, Md Sadique Hussain, Arcot Rekha, Gaurav Gupta","doi":"10.5493/wjem.v15.i4.110482","DOIUrl":"10.5493/wjem.v15.i4.110482","url":null,"abstract":"<p><p>Pinocembrin (PB) (5,7-dihydroxy flavanone) is a naturally occurring flavonoid sourced from propolis and Pinus spp., with the formula C₁₅H₁₂O₄ and moderate lipophilicity (log <i>P</i> approximately 2.1-2.5), which underlies both its bioactivity and formulation challenges. In rodents, oral administration yields rapid absorption but extensive first-pass glucuronidation and sulfation, resulting in conjugates that dominate plasma, limit bioavailability (< 10%) and confer a short half-life. <i>In vitro</i>, PB induces intrinsic mitochondrial apoptosis, downregulating Bcl-2, upregulating Bax, promoting cytochrome C release, and activating caspases-9/caspases-3 while inhibiting phosphoinositol-3 kinase/protein kinase B and STAT3 signaling, arresting cell-cycle progression, and suppressing metastatic markers (matrix metalloproteinase-9, vascular endothelial growth factor) across several cancer cell lines. Corresponding <i>in vivo</i> xenograft and orthotopic models demonstrate significant tumor growth inhibition, decreased Ki-67 indices, and increased cleaved caspase-3 without overt toxicity. To address solubility and clearance, MPEG-PDLLA micelles increased oral bioavailability by 5.3-fold and extended the half-life from 1.2 hours to 2.6 hours, while D-α-tocopheryl polyethylene glycol 1000 succinate liposomes achieved a 1.9-fold bioavailability increase and prolonged the half-life to 14.2 hours, indicating substantial pharmacokinetic (PK) enhancement and sustained systemic exposure in rodents. Toxicology studies report a no-observed-adverse-effect level ≥ 500 mg/kg in rats with no mutagenicity, and phase I trials (0.5-10 mg/kg) confirm human tolerability. Key gaps remain in target validation, long-term toxicity, and prodrug development. This review is novel in its integration of pharmacology, formulation advances, safety assessments, and translational considerations for PB. To our knowledge, it is the first to systematically compare multiple nanocarrier systems in terms of their ability to improve oral bioavailability and PK parameters of PB.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"110482"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel homozygous <i>C3orf67</i> gene variant associated with primary ciliary dyskinesia in a Saudi pediatric patient: A case report.","authors":"Fawzyh Alkhadidi, Hassan AlSharif, Amjad AlQthami, Safiah H Alkhaldi, Shaher A Alsuwat, Salma As Abosabie, Sara A Abosabie, Naglaa M Kamal","doi":"10.5493/wjem.v15.i4.108404","DOIUrl":"10.5493/wjem.v15.i4.108404","url":null,"abstract":"<p><strong>Background: </strong>Primary ciliary dyskinesia (PCD) is a rare genetic disorder caused by motile cilia dysfunction. Identifying pathogenic variants is essential for diagnosis and personalized care, especially in consanguineous populations like Saudi Arabia.</p><p><strong>Case summary: </strong>This report presents a Saudi pediatric patient diagnosed with PCD who exhibited persistent neonatal tachypnea, chronic productive cough, and recurrent otitis media. Whole-exome sequencing revealed a novel homozygous nonsense variant in the <i>C3orf67</i> gene (NM_198463.2:c.508C>T), resulting in a truncated, non-functional protein. This mutation likely impairs ciliary motility due to the production of a truncated, non-functional protein. The clinical findings were supported by multiple positive sputum cultures and a significant family history of similar symptoms, suggesting a genetic etiology consistent with autosomal recessive inheritance.</p><p><strong>Conclusion: </strong>This case highlights the importance of genetic studies in diagnosing PCD, particularly in communities with a high rate of consanguinity. The identification of a novel homozygous variant in the <i>C3orf67</i> gene expands the known genetic landscape of the disease. Further research is essential to clarify the functional role of <i>C3orf67</i> in ciliary biology and its contribution to PCD pathogenesis.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"108404"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthetic messenger RNA vaccines and transcriptomic dysregulation: Evidence from new-onset adverse events and cancers post-vaccination.","authors":"Natalia Lidmar Von Ranke, Wei Zhang, Philipp Anokhin, Nicolas Hulscher, Kevin McKernan, Peter Mccullough, John Catanzaro","doi":"10.5493/wjem.v15.i4.113869","DOIUrl":"10.5493/wjem.v15.i4.113869","url":null,"abstract":"<p><strong>Background: </strong>Synthetic messenger RNA (mRNA) vaccines have raised concerns regarding prolonged spike protein expression, immune activation, and potential off-target effects.</p><p><strong>Aim: </strong>To investigate transcriptomic alterations in individuals with new-onset adverse events or cancer following mRNA coronavirus disease 2019 vaccination.</p><p><strong>Methods: </strong>Bulk RNA sequencing was performed on peripheral blood from two patient groups: (1) Individuals with new-onset nonmalignant adverse events; and (2) Individuals newly diagnosed with cancer post-vaccination. A control group of normal individuals was used for comparison. Differential gene expression was analyzed using DESeq2, and Gene Set Enrichment Analysis was conducted using the MSigDB database and custom gene sets.</p><p><strong>Results: </strong>Both vaccine patient groups displayed widespread transcriptional dysregulation. In the nonmalignant adverse event group, hallmark enrichments included mitochondrial dysfunction, proteasome-mediated stress, transcriptomic instability, and systemic inflammation. The cancer group exhibited additional hallmarks of genomic instability and epigenetic reprogramming. Nonsense-mediated decay, ribosomal stress, and myelocytomatosis oncogene activation were prominent in both groups, while immune signaling <i>via</i> toll-like receptors and type I interferons was particularly elevated in cancer patients. The observed transcriptomic profiles indicate cellular stress responses, mitochondrial dysfunction, and immune dysregulation following exposure to mRNA vaccines, potentially in susceptible individuals.</p><p><strong>Conclusion: </strong>Shared and distinct molecular signatures in both cohorts demonstrate underlying mechanisms contributing to post-vaccine symptomatology and complications, including oncogenesis and or progression of malignant disease. These findings underscore the need for a deeper investigation into the long-term safety of mRNA vaccines and host response variability.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"113869"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of inflammatory, genetic, and epigenetic markers with Kellgren-Lawrence grading in post-traumatic osteoarthritis of knee: A protocol.","authors":"Keerthy Rethinam Meenakshi Sundaram, Thiagarajan Keddin Alwar, Ramchand Nannapan, Vinodhini Vellore Mohanakrishnan, Santhi Silambanan","doi":"10.5493/wjem.v15.i4.107843","DOIUrl":"10.5493/wjem.v15.i4.107843","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic osteoarthritis (PTOA) occurs due to cartilage degeneration caused by injuries like bone fractures, ligament tears, and soft tissue injuries in and around the joint. It is diagnosed by X-ray in the later stages. Early diagnosis may be possible by analyzing biochemical and molecular markers, facilitating early management.</p><p><strong>Aim: </strong>To characterize inflammatory, genetic, and epigenetic markers that aid in the diagnosis and prognosis of knee PTOA.</p><p><strong>Methods: </strong>The prospective cohort study is conducted at a tertiary care hospital, India. The study includes 140 participants: 70 (controls), and 70 (cases) sustained trauma to knee. Written informed consent is obtained. Serum interleukin (IL)-6, IL-1β, IL-10, cartilage oligomeric matrix protein, transforming growth factor-β1, matrix metalloproteinase-13, and oxidized-LDL and urine C-terminal cross-linked telopeptides of type II collagen are analyzed by ELISA. Genetic and epigenetic studies are done. Ethics approval is obtained. Statistical analysis by SPSS software version 16.</p><p><strong>Results: </strong>Biomarkers will be correlated with the X-ray grading as per the Kellgren-Lawrence scale.</p><p><strong>Conclusion: </strong>These mediators can be potential markers to assess the disease burden, prognosis, and severity. They may also help as therapeutic targets to customize personalized therapy.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"107843"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ganglion cell complex and retinal nerve fiber layer thickness in predicting visual outcome in brain tumors after surgery.","authors":"Sucheta Parija, Koyel Chakraborty, Rabi Narayan Sahu, Bhagabat Nayak, Ravikumar Subraya Rathod","doi":"10.5493/wjem.v15.i4.108702","DOIUrl":"10.5493/wjem.v15.i4.108702","url":null,"abstract":"<p><strong>Background: </strong>Anterior visual pathway lesions can cause severe visual loss. Optical coherence tomography (OCT) can detect ganglion cell complex (GCC) thinning, even with normal retinal nerve fiber layer (RNFL) thickness and subtle visual field changes.</p><p><strong>Aim: </strong>To determine the proportion of eyes with RNFL and GCC thinning and their association with visual parameters in patients with brain tumors undergoing surgery.</p><p><strong>Methods: </strong>A prospective study was conducted on 37 patients (69 eyes) with peri-chiasmatic and chiasmatic brain tumors undergoing surgical decompression between February 2019 and June 2020 at a tertiary care institute. A comprehensive neuro-ophthalmological work-up, demographic and clinical profile documentation, and six-month postoperative follow-up weredone. Statistical analysis was significant at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Mean age was 35.14 ± 11.98 years. The best and worst visual outcomes were associated with the craniopharyngioma and meningioma groups, respectively (<i>P</i> = 0.008). There was an increase in the proportion of eyes with RNFL damage in the inferior quadrant (<i>P</i> = 0.02). Maximum GCC thickness thinning was associated with severe visual impairment. The odds of having blindness in eyes with RNFL (inferior) and GCC loss were 0.96 (<i>P</i> = 0.003) and 0.95 (<i>P</i> = 0.03), respectively. GCC thickness showed a clinically positive correlation with visual acuity (<i>r</i> = -0.48, <i>P</i> < 0.001) and field defect (<i>r</i> = -0.27, <i>P</i> = 0.04) at six months postoperatively. The preoperative GCC thickness and the final postoperative visual outcome were plotted in an empirical ROC curve with area under the curve = 0.754. The cut-off value of RNFL (inferior) and GCC, beyond which blindness could be prevented, was 73 µm and 58 µm, respectively.</p><p><strong>Conclusion: </strong>In chiasmal compression, RNFL and GCC thickness measurements using OCT can be a useful prognostic indicator for assessing visual recovery. An eye with structural damage, with significant RNFL and GCC loss, is a predictive factor of blindness. A minimum preoperative RNFL and GCC thickness of 73 µm and 58 µm, respectively, can preserve vision after surgery.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"108702"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating palmitoyl-protein thioesterase 1 in oral squamous cell carcinoma: A novel indicator of tumor behavior and therapeutic response.","authors":"Kurundhalingam Chinniah Pradheep Kumar, Sanjukta Sahoo, Amit Kumar Adhya, Manisha R Gaikwad, Arthi Ganapathy, Praveen Kumar Ravi","doi":"10.5493/wjem.v15.i4.110917","DOIUrl":"10.5493/wjem.v15.i4.110917","url":null,"abstract":"<p><strong>Background: </strong>Oral squamous cell carcinoma (OSCC) poses a major health burden, with frequent late-stage diagnoses and limited prognostic tools. Palmitoyl-protein thioesterase (PPT)1, a lysosomal enzyme, has been implicated in tumor biology. This study investigates PPT1 expression in OSCC and its association with clinicopathological features.</p><p><strong>Aim: </strong>To evaluate the immunohistochemical expression of PPT1 in OSCC and assess its correlation with patient age, gender, tumor grade, and TNM staging using H-score quantification.</p><p><strong>Methods: </strong>Immunohistochemistry for PPT1 was performed on 43 histopathologically confirmed OSCC samples. PPT1 expression was quantified using the H-score method (range: 0-300). Correlation with clinical parameters was assessed using Spearman's rank correlation and Kruskal-Wallis test.</p><p><strong>Results: </strong>PPT1 expression showed a significant positive correlation with tumor grade (ρ = 0.48, <i>P</i> = 0.0015), while a weak, nonsignificant negative correlation was noted with patient age (ρ = -0.27, <i>P</i> = 0.083). No significant differences were found by gender or tumor stage. Given the small sample size, these findings should be interpreted as preliminary.</p><p><strong>Conclusion: </strong>PPT1 expression is associated with histological tumor grade in OSCC and may reflect tumor aggressiveness. These initial results highlight the potential of PPT1 as a prognostic biomarker, warranting further validation in larger, multicenter studies.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"110917"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual incretin analogue tirzepitide - SURMOUNTing the challenge of obesity induced obstructive sleep apnea.","authors":"Jyoti Bajpai, Mehul Saxena, Utkarsh Agarwal, Akshyaya Pradhan","doi":"10.5493/wjem.v15.i4.109762","DOIUrl":"10.5493/wjem.v15.i4.109762","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a prevalent and underdiagnosed sleep disorder strongly associated with obesity. Traditional therapies such as continuous positive airway pressure are effective but often limited by poor adherence. Recent evidence suggests that tirzepatide, a dual glucagon like receptor-1 and glucose dependent insulinotropic polypeptide receptor agonist, may offer a pharmacologic approach to OSA management through its weight-reducing and metabolic effects. This narrative review was conducted using a structured search of PubMed, Google Scholar, and Scopus databases for English-language articles published up to May 2024. Keywords included \"tirzepatide\", \"obstructive sleep apnea\", \"OSA\", and \"GLP-1 agonist\". Clinical trials, systematic reviews, and relevant observational studies focusing on tirzepatide's role in OSA or obesity were included and thematically analyzed. Emerging evidence from the SURMOUNT-OSA and related trials indicates that tirzepatide leads to clinically significant reductions in body weight, apnea-hypopnea index, and systemic inflammation. The drug was found to be effective and also showed additional benefits in sleep quality and cardiovascular risk factors. Tirzepatide represents a promising pharmacologic advancement in the management of obesity-related OSA. By targeting both metabolic and structural contributors to OSA, it may serve as an adjunct or alternative to traditional therapies. Further research is warranted to evaluate long-term outcomes and to define its role in clinical practice guidelines.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"109762"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of beta-blockers in the treatment of hematidrosis: A systematic review.","authors":"Ahmet Alperen Palabiyik","doi":"10.5493/wjem.v15.i4.110936","DOIUrl":"10.5493/wjem.v15.i4.110936","url":null,"abstract":"<p><strong>Background: </strong>Hematidrosis is an extremely rare and enigmatic condition characterized by spontaneous bleeding through intact skin or mucosa, typically occurring in response to severe emotional stress. Although its exact pathophysiology remains unclear, the condition is thought to involve sympathetic nervous system overactivation and capillary fragility, leading to blood extravasation <i>via</i> sweat glands or hair follicles.</p><p><strong>Aim: </strong>To evaluate the efficacy and safety of beta-blockers, particularly propranolol, in the management of hematidrosis.</p><p><strong>Methods: </strong>A systematic literature search was conducted in January 2024 across six major databases to identify studies published between 2014 and 2024 that reported the use of beta-blockers in patients with hematidrosis. Eligible studies included clinical case reports or case series that described beta-blocker treatment outcomes. Data were synthesized narratively in accordance with the PRISMA 2020 guidelines.</p><p><strong>Results: </strong>Twenty studies met the inclusion criteria. Among them, propranolol was the most frequently prescribed beta-blocker and was associated with symptomatic improvement in over 75% of cases. Some studies also reported enhanced outcomes when beta-blockers were used in conjunction with psychotherapy. Reported adverse effects were minimal, and treatment was generally well-tolerated. However, the available evidence remains limited to low-level observational data, mostly case reports and small case series.</p><p><strong>Conclusion: </strong>Beta-blockers, especially propranolol, appear to be an effective and well-tolerated treatment option for hematidrosis, particularly in stress-induced presentations. Despite promising findings, the evidence base is constrained by the lack of high-quality studies. Future research should focus on prospective, controlled trials to establish standardized diagnostic and treatment protocols for this rare condition.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 4","pages":"110936"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and risk factor analysis of post-vitrectomy silicone oil migration to the central nervous system.","authors":"Lucy Wing Wong, Wai Yan Lam, Sunny Chi Lik Au","doi":"10.5493/wjem.v15.i3.106429","DOIUrl":"10.5493/wjem.v15.i3.106429","url":null,"abstract":"<p><strong>Background: </strong>Silicone oil (SiO) migration to the central nervous system (CNS) is a rare complication of SiO tamponade after vitreo-retinal surgeries, it could masquerade hemorrhage on computed tomography neuro-imaging. Only limited cases were reported in the literature, certain intra-operative and post-operative ocular risk factors might contribute to the different extend of SiO migration in the CNS.</p><p><strong>Aim: </strong>To study the risk factors for cerebral ventricular migration (CVM) on top of visual pathway migration (VPM).</p><p><strong>Methods: </strong>Conforming to the preferred reporting items for systematic reviews and meta-analyses guidelines, literature searches on PubMed, MEDLINE, EMBASE were performed on June 1, 2024. Publications on SiO migration to CNS were included in this review. Non-English articles, and studies without neuro-imaging of the CNS were excluded. Patient demographics, SiO filled eyes' ocular characteristics and vitrectomy surgical details were extracted from included studies in this review. VPM and CVM were assigned as group 1 and group 2 respectively. Fisher's exact tests, Mann-Whitney <i>U</i> tests and binary logistic regression were performed.</p><p><strong>Results: </strong>Total 68 articles were obtained after searches, 48 publications were included for analysis. Total 54 SiO filled eyes were analyzed. Post-vitrectomy intraocular pressure (IOP) was found to be significant in both Mann-Whitney <i>U</i> test (<i>P</i> = 0.047) and binary logistic regression (<i>P</i> = 0.012). Diabetic was found to be significant in binary logistic regression (<i>P</i> = 0.037), but at borderline risk for CVM in Fisher's exact test (<i>P</i> = 0.05). Other significant factors include longer SiO tamponade time (<i>P</i> = 0.002 in Fisher's exact test) and visual acuity (<i>P</i> = 0.011 in binary logistic regression). Optic nerve atrophy or disc cupping (<i>P</i> = 1.00, <i>P</i> = 0.790) and congenital optic disc anomalies (<i>P</i> = 0.424) were all with <i>P</i> > 0.05.</p><p><strong>Conclusion: </strong>SiO migration to CNS is rare with limited case reports only. Our analysis of the existing literature demonstrated higher post-vitrectomy IOP was associated with CVM, followed by patients' diabetic status, longer SiO tamponade time and visual acuity. Optic nerve atrophy, disc cupping and congenital optic disc anomalies were not associated. Modifiable risk factors of post-vitrectomy IOP and SiO tamponade time should be closely monitored by vitreo-retinal surgeons. Lower IOP target post-vitrectomy and earlier SiO removal surgeries should be arranged.</p>","PeriodicalId":75340,"journal":{"name":"World journal of experimental medicine","volume":"15 3","pages":"106429"},"PeriodicalIF":0.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}